12350 Federal Register / Vol. 89, No. 33 / Friday, February 16, 2024 / Notices 

Jeffrey M. Zirger, 

Lead, Information Collection Review Office, 

Office of Public Health Ethics and 

Regulations, Office of Science, Centers for 

Disease Control and Prevention. 

[FR Doc. 2024–03239 Filed 2–15–24; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifiers: CMS–10884 and 

CMS–855A] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

Services (HHS). 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), Federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates or any other aspect of 

this collection of information, including 

the necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions, 

the accuracy of the estimated burden, 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected, and the use of automated 

collection techniques or other forms of 

information technology to minimize the 

information collection burden. 

DATES: Comments must be received by 

April 16, 2024. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. To be assured 

consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send your 

comments electronically to http://

www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) that are accepting 

comments. 

2. By regular mail. You may mail 

written comments to the following 

address: CMS, Office of Strategic 

Operations and Regulatory Affairs, 

Division of Regulations Development, 

Attention: Document Identifier/OMB 

Control Number: ll, Room C4–26–05, 

7500 Security Boulevard, Baltimore, 

Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, please access the CMS PRA 

website by copying and pasting the 

following web address into your web 

browser: https://www.cms.gov/ 

Regulations-and-Guidance/Legislation/ 

PaperworkReductionActof1995/PRAListing. 

FOR FURTHER INFORMATION CONTACT: 

William N. Parham at (410) 786–4669. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

CMS–10884 Prior Authorization 

Demonstration for Certain 

Ambulatory Surgical Center (ASC) 

Services 

CMS–855A Medicare Enrollment 

Application for Institutional Providers 

Under the PRA (44 U.S.C. 3501– 

3520), Federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires Federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: New collection (Request for a 

new OMB control number); Title of 

Information Collection: Prior 

Authorization Demonstration for Certain 

Ambulatory Surgical Center (ASC) 

Services; Use: Section 402(a)(1)(J) of the 

Social Security Amendments of 1967 

(42 U.S.C. 1395b-1(a)(1)(J)) authorizes 

the Secretary to ‘‘develop or 

demonstrate improved methods for the 

investigation and prosecution of fraud 

in the provision of care or services 

under the health programs established 

by the Social Security Act (the Act).’’ 

Pursuant to this authority, CMS seeks to 

develop and implement a Medicare 

demonstration project, which CMS 

believes will assist in developing 

improved procedures for the 

identification, investigation, and 

prosecution of Medicare fraud occurring 

in ambulatory surgical centers providing 

services to Medicare beneficiaries. 

The information required for the prior 

authorization request includes all 

documentation necessary to show that 

the service meets applicable Medicare 

coverage, coding, and payment rules. 

Prior to rendering the services, ASC 

providers should submit this 

information to the Medicare 

Administrative Contractors (MACs). 

Trained clinical reviewers at the MACs 

will review the information required for 

this collection to determine if the 

requested services are medically 

necessary and meet Medicare 

requirements. If an ASC provider does 

not submit a prior authorization request 

before rendering the service and 

submitting a claim to Medicare for 

payment, the MAC will request the 

required information from the ASC 

provider to determine if the service 

meets applicable Medicare coverage, 

coding, and payment rules before the 

claim is paid. Form Number: CMS– 

10884 (OMB Control Number: 0938– 

NEW); Frequency: Occasionally; 

Affected Public: Business or other forprofits; Number of Respondents: 4,038; 

Number of Responses: 95,579; Total 

Annual Hours: 59,904. (For policy 

questions regarding this collection 

contact Kelly Wojciechowski at 

kelly.wojciechowski@cms.hhs.gov or 

Justin Carlisle at Justin.Carlisle@

cms.hhs.gov). 

2. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application for Institutional 

Providers; Use: Various sections of the 

Social Security Act (Act), the United 

States Code (U.S.C.), Internal Revenue 

Service Code (Code) and the Code of 

Federal Regulations (CFR) require 

providers and suppliers to furnish 

information concerning the amounts 

due and the identification of individuals 

or entities that furnish medical services 

to beneficiaries before payment can be 

made. 


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Federal Register / Vol. 89, No. 33 / Friday, February 16, 2024 / Notices 12351 

The primary function of the CMS– 

855A Medicare enrollment application 

is to gather information from a certified 

provider or certified supplier (hereafter 

occasionally and collectively referenced 

as ‘‘provider(s)’’) that tells us who it is, 

whether it meets certain qualifications 

to be a health care provider, where it 

practices or renders services, the 

identity of its owners, and other 

information necessary to establish 

correct claims payments. Form Number: 

CMS–855A (OMB control number: 

0938–0685); Frequency: On occasion; 

Affected Public: Business or other forprofits, not-for-profit institutions; 

Number of Respondents: 45,473; Total 

Annual Responses: 217,493; Total 

Annual Hours: 41,120. (For policy 

questions regarding this collection 

contact Frank Whelan at 410–786– 

1302.) 

William N. Parham, III, 

Director, Division of Information Collections 

and Regulatory Impacts, Office of Strategic 

Operations and Regulatory Affairs. 

[FR Doc. 2024–03294 Filed 2–15–24; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for Office of Management 

and Budget Review; Healthy Marriage 

and Responsible Fatherhood 

Performance Measures and Additional 

Data Collection (Office of Management 

and Budget #0970–0566) 

AGENCY: Office of Planning, Research, 

and Evaluation, Administration for 

Children and Families, U.S. Department 

of Health and Human Services. 

ACTION: Request for public comments. 

SUMMARY: The Administration for 

Children and Families (ACF), Office of 

Family Assistance (OFA), is requesting 

an extension with changes to its 

approved collection and reporting of 

performance measures about program 

operations, services, and clients served 

through the Healthy Marriage (HM) and 

Responsible Fatherhood (RF) grant 

programs. In an effort to gain a great 

understanding of how HMRF programs 

influence program participants and staff 

at an individual level, ACF proposes to 

add one open field to the quarterly 

narrative reports to capture information 

about the experiences of HMRF 

participants and/or staff. ACF is 

requesting to extend approval, with the 

implementation of this change, for 3 

years. 

DATES: Comments due within 30 days of 

publication. OMB must make a decision 

about the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. You can also obtain 

copies of the proposed collection of 

information by emailing 

OPREinfocollection@acf.hhs.gov. 

Identify all requests by the title of the 

information collection. 

SUPPLEMENTARY INFORMATION: 

Description: ACF proposes to continue 

collecting a set of Office of Management 

and Budget (OMB)-approved 

performance measures from all HMRF 

award recipients. 

The HMRF performance measures 

collect standardized information in the 

following areas: 

• Applicant characteristics; 

• Program operations; 

• Service delivery; and 

• Participant outcomes: 

Æ Entrance survey, with five versions: 

(1) HM Program Entrance Survey for 

Adult-Focused Programs; (2) HM 

Program Entrance Survey for YouthFocused Programs; (3) RF Program 

Entrance Survey for Community-Based 

Fathers; (4) RF Program Entrance Survey 

for Community-Based Mothers; and (5) 

RF Program Entrance Survey for 

Reentering Fathers. 

Æ Exit survey, with five versions: (1) 

HM Program Exit Survey for AdultFocused Programs; (2) HM Program Exit 

Survey for Youth-Focused Programs; (3) 

RF Program Exit Survey for CommunityBased Fathers; (4) RF Program Exit 

Survey for Community-Based Mothers; 

and (5) RF Program Exit Survey for 

Reentering Fathers. 

The measures were developed in 2014 

after extensive review of the research 

literature and recipients’ past measures. 

They were revised in 2020 based on a 

targeted analysis of existing measures, 

feedback from key audiences, and 

discussions with ACF staff and the 2015 

cohort of recipients. OMB approved 

these revised measures in 2021 and has 

approved a handful of non-substantive 

changes since then. 

ACF also proposes to continue the 

OMB-approved quarterly reporting on 

the following measures, with minor 

changes as described: 

• Semi-annual Performance Progress 

Report (PPR), with two versions: (1) 

Performance Progress Report for HM 

Programs, and (2) Performance Progress 

Report for RF Programs; and 

• Quarterly Performance Report 

(QPR), with two versions: (1) Quarterly 

Performance Progress Report for HM 

Programs, and (2) Quarterly 

Performance Progress Report for RF 

Programs. ACF proposes to add a new 

text box to the QPRs to gather 

qualitative narratives of the experiences 

of HMRF participants and/or staff. This 

information will help build ACF’s 

understanding of how HMRF programs 

influence program participants and staff 

at an individual level. 

ACF provides recipients with a webbased performance measures data 

collection system called nFORM 2.0 

(Information, Family Outcomes, 

Reporting, and Management) to improve 

the efficiency of data collection and 

reporting and the quality of data. This 

system allows for streamlined and 

standardized submission of recipient 

performance data through regular 

progress reports and supports recipientled and federal research projects. 

ACF also proposes to continue the 

OMB-approved requirement for 

recipients to document their continuous 

quality improvement (CQI) planning 

and implementation using a CQI plan 

template that is completed outside of 

the nFORM system. 

Respondents: Respondents include 

HM and RF award recipient staff and 

program applicants and participants 

(participants are called ‘‘clients’’). 

Annual Burden Estimates: The 

estimated number of respondents for 

each instrument has been adjusted to 

reflect experiences in the field to date. 

There is no change to the average 

estimated time per response of any 

instrument. 


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